ObjectiveTo observe the macular morphological development and thickness of retinal layers in infants. MethodsFifty-eight infants (86 eyes) were randomly selected from neonatal intensive care unit. They were divided into 4 groups according to the corrected gestational age, including <32 weeks group (10 cases, 14 eyes), 33 to 36 weeks group (26 cases, 39 eyes), 37 to 41 weeks group (12 patients, 18 eyes) and ≥42 weeks group (10 cases,15 eyes). Twelve health adults (22 eyes) were randomly selected as adult group. All infants and adults underwent a portable optical coherence tomography (OCT) examination, focus on the macular morphology. The thickness of 9 retinal layers at fovea and parafovea (750 μm, 1500 μm from central fovea) were measured, including retinal neurepithelium layer, the inner retina, the outer retina, nerve fiber layer, ganglion cell layer, inner plexiform layer, inner nuclear layer, outer plexiform layer and inner nuclear layer. The correlation between retinal thickness and corrected gestational age was analyzed. ResultsMacular fovea was shallow in early infancy, and then form a mature macular fovea finally with corrected gestational age. The outer retina structure was more mature than the inner retina of infants. With the increase of the corrected gestational age, the following structures gradually developed including the outer limiting membrane (OLM), the junction of inner and outer segment of photoreceptor (IS/OS), the outer segment of photoreceptor/retinal pigment epithelium layer (OS/RPE). The earliest corrected gestational age to detect the OLM, IS/OS, OS/RPE was 32+6, 35, 47+6 weeks respectively. The RPE and choroid layer became thicker gradually. There were no statistical differences between infants group and adults group (P>0.01) for the following thickness measurements, including inner retina at 750 μm parafovea, nerve fiber layer at 1500 μm parafovea, ganglion cell layer at central fovea and parafovea (750 μm, 1500 μm). The thickness of other retinal layers was different between different sites, between different corrected gestational ages, and between infants and adults groups (P<0.01). Correlation analysis found that, except of retinal ganglion cell layer, the thickness of other retinal layers was correlated with the corrected gestational age (P<0.05). ConclusionsMacular fovea is shallow in early infancy, and then form a mature macular fovea finally with corrected gestational age. At infant's early stage, the outer retina of macular is gradually thickening, of which the most obvious variation are the inner nuclear layer and outer nuclear layer. But the development speed of all layers is inconformity.
ObjectiveTo observe the retinal reattachment of suprachoroidal injection with sodium hyaluronate in the treatment of rhegmatogenous retinal detachment (RRD).MethodsTwelve eyes of 12 patients with RRD diagnosed by the examinations of B-mode ultrasound, binocular indirect ophthalmoscope, OCT and scanning laser ophthalmoscope in West China Hospital of Sichuan University from October 2018 to February 2019 were included in this study. There were 7 males and 5 females, aged from 15 to 66 years, with the mean age of 32.40±14.81 years. There were 4 eyes with BCVA＜0.1, 4 eyes with BCVA 0.1-0.4, 4 eyes with BCVA＞0.4. The extent of retinal detachment involves 1 to 4 quadrants. All eyes were injected with sodium hyaluronate via suprachoroidal space under non-contact wide-angle system. Surgery was performed by the same ophthalmologist with extensive surgical experience. During the operation, the retinal hole was handled with scleral freezing and laser photocoagulation. The follow-up was 2 months. The retinal reattachment was observed.ResultsOf the 12 eyes, 6 eyes (50.00%) were anatomically reattached, 4 eyes (33.33%) ere partly anatomically reattached with subretinal fluid, 2 eyes (16.67%) were not reattached. The holes in 4 eyes of partly anatomically reattached with subretinal fluid were located on the choroidal pad and the holes were closed, in addition, the subretinal fluid gradually absorbed over time. Two eyes failed in retinal reattachment received vitrectomy with silicone oil tamponade or sclera buckling surgery. No severe complications such as endophthalmitis and choroidal hemorrhage were found at follow-up visits.ConclusionSuprachoroidal injection of sodium hyaluronate is an effective and safe treatment for RRD, which can promote retinal reattachment.